Individual provider Active NPI

Mark Louis Manwaring, MD

  • Surgery Physician
  • Murfreesboro, TN
National Provider Identifier
1912107277
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2006-01186 Issued in NC
Practice address
1800 Medical Center Pkwy Ste 440
Murfreesboro, TN 37129
Phone
(615) 867-1940
Fax
(615) 867-1941
NPI assigned
Jul 24, 2007
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2006-01186 NC Primary

Addresses

Primary practice location

1800 Medical Center Pkwy Ste 440
Murfreesboro, TN 37129

Mailing address

300 20TH Ave N Ste 403
Nashville, TN 37203-5180
Phone (615) 867-1940

Other identifiers 4

IdentifierTypeStateIssuer
Q034047MedicaidTN
1912107277MedicaidNC
NC14930322OtherNCMEDICARE
163XKOtherNCBCBSNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180627003693 TN Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 8527238120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
State University of New York at Buffalo School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

300 20TH Ave N
Nashville, TN 37203-2131
Phone (615) 284-1400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-01186NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince Jul 1, 2018 Accepting new patients

Locations

1800 Medical Center Pkwy
#4
Murfreesboro, TN 37129

1800 Medical Center Pkwy
Ste 410
Murfreesboro, TN 37129
Phone (615) 396-6800

1800 Medical Center Pkwy
Ste 440
Murfreesboro, TN 37129
Phone (615) 867-1940

300 20th Ave N
Fl 9
Nashville, TN 37203

300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088

Interoperability endpoints

  • Direct secure messaging: mark.manwaring.1@7654.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1912107277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 20TH AVE N STE 403",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035180",
            "telephone_number": "615-867-1940",
            "fax_number": "615-867-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MEDICAL CENTER PKWY STE 440",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37129",
            "telephone_number": "615-867-1940",
            "fax_number": "615-867-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANWARING",
        "first_name": "MARK",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2006-01186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q034047",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912107277",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NC14930322",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "163XK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.